ADVANCED ENDOSCOPY

A 72-year-old female with progressive dysphagia over two years. Endoscopy revealed a 5 cm proximal esophageal stenosis that could not be traversed with a standard gastroscope; a 5.8 mm pediatric gastroscope was used to pass the segment. Biopsies were negative for malignancy but positive for Candida. A repeat endoscopy is planned to assess healing and evaluate for possible esophageal lichen planus.

Rectal adenoma recurrence beneath a retained over-the-scope clip after previous EMR complicated by significant bleeding.
During follow-up, adenomatous tissue was identified growing under the OTSC. Attempted clip removal with an OTSC cutter was unsuccessful. The case highlights the role of endoscopic intermuscular dissection (EID) as a salvage strategy, which was successfully performed to achieve complete resection.

In patients with inflammatory bowel disease (IBD), cytomegalovirus (CMV) infection remains an important—and often underrecognized—clinical challenge. Its presentation can be variable, and distinguishing a true IBD flare from CMV colitis has major therapeutic implications. This video explores key clinical scenarios and practical approaches to diagnosis and management.

In this video, we show a case of post-polypectomy bleeding in the gastric fundus, managed in a technically challenging position with limited scope stability and poor maneuverability. This video demonstrates the endoscopic problem-solving required when access is awkward, visualization is suboptimal, and hemostasis depends on using all available tools effectively.